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UnitedHealthcare: PDL Strategy for Recent Launch of Generic Abilify

Originally Shared by UnitedHealthcare on May 19, 2015

On April 28, 2015, the FDA approved the first generic version of Abilify® (aripiprazole), an antipsychotic medication used to treat schizophrenia, bipolar disorder, depression and other mental health conditions. Based on the high cost of this medication, brand Abilify will be excluded from coverage effective August 1, 2015 on both the Advantage and Traditional PDLs. Generic Abilify (aripiprazole) will be placed in Tier 3 on the Advantage PDL and Tier 1 on the Traditional PDL. 

Due to the timing of the generic launch, this exclusion is taking place off cycle from our standard January 1 and July 1 changes.  Therefore, coverage (covered or excluded) for this medication for self-funded customers will follow their July 1, 2015 coverage decisions. Brand Abilify will be:

-Covered for clients that opt out of all exclusions and placed in the highest tier (Note: brand Abilify is already in the highest tier)

-Excluded for clients that opt into all exclusions OR those that elected to exclude Versacloz (7/1/15 excluded medication in the same drug class)

Member letters will be mailed June 1 for fully-insured plans and self-funded clients that exclude brand Abilify. Letters will include the generic equivalent as the alternative. 

For fully-insured customers sitused in Louisiana and Texas, the PDL changes for Abilify will take place upon the group renewal date.

Questions? Contact Tanya@agent-link.net

Filed Under: News and Updates, United Healthcare

Previous Post: « Coming Soon to KY: UnitedHealthOne Individual Plans
Next Post: Important Notice for Agents Working with Assurant Health »

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